PMC:6964229 / 16276-18635 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/6964229","sourcedb":"PMC","sourceid":"6964229","source_url":"https://www.ncbi.nlm.nih.gov/pmc/6964229","text":"Late clinical results\nFrom cubic spline-based analyses, no evidence of non-linearity for post repair MV gradient was found for all time-to-event outcomes (Supplementary materials, Figures S3–S5). Hence, postrepair MV gradient was entered into the Cox proportional hazards regression analysis models as a continuous variable for all subsequent analyses.\nDuring a median follow-up period of 5.8 (IQR 3.4–9.3) years (99.5% complete, 2 patients were lost to follow-up due to emigration), 84 patients died. When corrected for patient age, gender, chronic pulmonary disease, renal impairment, left ventricular function, symptomatic MR and atrial fibrillation, postrepair MV gradients was not associated with patient survival [hazard ratio (HR) 1.034, 95% CI 0.889–1.203; P = 0.66; Supplementary material, Table S1].\nFollow-up on clinical related events was 90% complete with a mean duration of 5.2 (IQR 2.7–8.8) years. When adjusted for patient age, tricuspid valve repair and preoperative left atrial diameter, postrepair MV gradient was not associated with late atrial fibrillation occurrence (HR 0.849, 95% CI 0.682–1.057; P = 0.14; Supplementary material, Table S1).\nWhen adjusted for anterior MV leaflet repair, postrepair MV gradient was associated with a higher risk of MV reintervention (HR 1.378, 95% CI 1.033–1.838; P = 0.029; Supplementary material, Table S1). A total of 11 late reinterventions were performed. The indication for reintervention was recurrent MR in 9 patients and elevated MV gradient in the remaining 2 patients. In both of the latter patients, a postrepair gradient of ≥5 mmHg (5.88 and 5.23 mmHg, respectively) was seen on predischarge echocardiography, despite an acceptable gradient seen on intraoperative echocardiography (2.53 and 4.23 mmHg, respectively). In the first of the latter patients, an annuloplasty ring size 26 was initially implanted and a re-repair due to heart failure symptoms (no significant MR or other explanation for this observation were found) was performed 1.3 years after the initial operation. Upon reoperation, the annuloplasty ring was explanted, resolving the problem of elevated gradient. In the other patient, an annuloplasty ring size 32 was implanted during the initial operation. Severe pannus formation occurred and the patient underwent a valve replacement 1.1 years after the initial operation.","divisions":[{"label":"title","span":{"begin":0,"end":21}},{"label":"p","span":{"begin":22,"end":352}},{"label":"p","span":{"begin":353,"end":809}},{"label":"p","span":{"begin":810,"end":1164}}],"tracks":[{"project":"testtesttest","denotations":[{"id":"T116","span":{"begin":101,"end":103},"obj":"Body_part"},{"id":"T117","span":{"begin":214,"end":216},"obj":"Body_part"},{"id":"T118","span":{"begin":665,"end":667},"obj":"Body_part"},{"id":"T119","span":{"begin":944,"end":959},"obj":"Body_part"},{"id":"T120","span":{"begin":1017,"end":1019},"obj":"Body_part"},{"id":"T121","span":{"begin":1192,"end":1194},"obj":"Body_part"},{"id":"T122","span":{"begin":1222,"end":1224},"obj":"Body_part"},{"id":"T123","span":{"begin":1271,"end":1273},"obj":"Body_part"},{"id":"T124","span":{"begin":1495,"end":1497},"obj":"Body_part"},{"id":"T125","span":{"begin":1899,"end":1904},"obj":"Body_part"},{"id":"T129","span":{"begin":2303,"end":2308},"obj":"Body_part"}],"attributes":[{"id":"A116","pred":"uberon_id","subj":"T116","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A117","pred":"uberon_id","subj":"T117","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A118","pred":"uberon_id","subj":"T118","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A119","pred":"uberon_id","subj":"T119","obj":"http://purl.obolibrary.org/obo/UBERON_0002134"},{"id":"A120","pred":"uberon_id","subj":"T120","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A121","pred":"uberon_id","subj":"T121","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A122","pred":"uberon_id","subj":"T122","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A123","pred":"uberon_id","subj":"T123","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A124","pred":"uberon_id","subj":"T124","obj":"http://purl.obolibrary.org/obo/UBERON_0002135"},{"id":"A125","pred":"uberon_id","subj":"T125","obj":"http://purl.obolibrary.org/obo/UBERON_0000948"},{"id":"A126","pred":"uberon_id","subj":"T125","obj":"http://purl.obolibrary.org/obo/UBERON_0007100"},{"id":"A127","pred":"uberon_id","subj":"T125","obj":"http://purl.obolibrary.org/obo/UBERON_0015228"},{"id":"A128","pred":"uberon_id","subj":"T125","obj":"http://purl.obolibrary.org/obo/UBERON_0015230"},{"id":"A129","pred":"uberon_id","subj":"T129","obj":"http://purl.obolibrary.org/obo/UBERON_0003978"},{"subj":"T116","pred":"source","obj":"testtesttest"},{"subj":"T117","pred":"source","obj":"testtesttest"},{"subj":"T118","pred":"source","obj":"testtesttest"},{"subj":"T119","pred":"source","obj":"testtesttest"},{"subj":"T120","pred":"source","obj":"testtesttest"},{"subj":"T121","pred":"source","obj":"testtesttest"},{"subj":"T122","pred":"source","obj":"testtesttest"},{"subj":"T123","pred":"source","obj":"testtesttest"},{"subj":"T124","pred":"source","obj":"testtesttest"},{"subj":"T125","pred":"source","obj":"testtesttest"},{"subj":"T129","pred":"source","obj":"testtesttest"}]}],"config":{"attribute types":[{"pred":"source","value type":"selection","values":[{"id":"testtesttest","color":"#ecc093","default":true}]}]}}